CMS Formulary

Displaying 134721-134730 of 1611142 results.
ID: 134721
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134722
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134723
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134724
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134725
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134726
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134727
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 134728
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134729
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134730
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0